Creatine is one of the most-studied sports supplements, with over 2,000 studies to date. And that research is largely consistent in showing that creatine does provide some benefit to most people who take it.
And yet it isn't exactly clear about how, exactly, creatine monohydrate achieves these benefits, as Brad Schoenfeld, Ph.D., CSCS, explains in the article "Ask the Muscle Doc: How Does Creatine Help Muscle Gains?" One explanation is that since creatine boosts strength gains, it allows lifters to move more overall weight and generate more of what is called "mechanical tension." Mechanical tension is known to be one of the primary creators of muscle growth.
However, it's also possible that because creatine draws water into muscle cells, it contributes to another one of the creators of muscle growth, cellular swelling. The third of the major mechanisms of muscle growth is muscular damage.
"It's entirely possible that creatine can positively impact two, or even all three, of those mechanisms," Schoenfeld writes.